- Pilot Study Program
San Francisco Treatment Research Center
The San Francisco Treatment Research Center (SFTRC) at the University of California, San Francisco (UCSF), is a Center funded by the National Institute on Drug Abuse conducting a variety of studies focused on innovative treatments for substance abuse. Our research includes both psychosocial and pharmacologic trials in both randomized clinical trial and Phase I development forms. We conduct our work at UCSF and its affiliated sites at the San Francisco Veterans Affairs Medical Center and San Francisco General Hospital and the Habit Abatement Clinic.
NIH Award: The Impact of Health Care Reform on Addiction and HIV Services
Derek Satre and Cynthia Campbell recently received notice of an R21 award (DA035645-01) entitled: The Impact of Health Care Reform on Addiction and HIV Services. This was one of 5 awards made under an RFA designed to study the impacts of the Affordable Care Act (ACA) in drug abuse treatment. The study focuses on key elements of the ACA that will be implemented in 2014 and will likely increase demand for substance use disorder (SUD) and HIV treatment services. The project evaluates the impact of the ACA on individuals with SUDs in a care setting well-suited to ACA implementation research. Kaiser Permanente Northern California (KPNC) is a large health care system providing integrated SUD and medical treatment. The study's innovative approach is informed by an integrated conceptual model of organizational theory and health service utilization. In this phased study, the Aims of the R21 phase lay the groundwork for analyzing changes in membership demographics and clinical complexity, services use and costs, using a cohort (n=3641) of newly enrolled pre-ACA health plan members with SUDs, including members with both SUDs and HIV. In the R33 phase, we use a pre-post design to compare the R21 cohort to a second, post-ACA cohort of newly enrolled KPNC members with SUDs, using advanced difference-in-difference methods to analyze ACA-related changes that begin in 2014. Key outcomes include membership changes, health services utilization and costs, SUD treatment initiation and retention, and HIV management. The post-ACA cohort will also be followed longitudinally over two years. With an innovative mixed-methods approach, we use data from the health plan’s extensive electronic medical record, supplemented by qualitative interviews with organizational and clinical leaders regarding ACA-related changes to benefit plans, service delivery, workforce, and barriers or facilitators that impact ACA implementation. Findings will be highly informative in understanding how health plans implement the ACA and serve newly insured SUD and HIV patient populations, and will contribute to future health policy.